The present invention relates to a compression hose of elastic material for exerting tissue pressure on an arm of a patient, in which the compression hose comprises a shoulder part which partially covers the shoulder joint when in use, while fastening means for fastening the compression hose are provided on the shoulder part.
Such a compression hose is known in practice and is generally used to counteract oedema formation in an arm in an oedematous patient. For this purpose, the elastic material of the arm part has a predetermined compression value. The known compression hose is provided with a narrow shoulder part which is approximately 8 to 10 cm wide and serves to fasten a band of elastic material by means of which the compression hose, is fastened to the trunk of the patient.
The object of the compression hose according to the present invention, is to solve very specific and commonly occurring problems in a particular group of oncology patients to which until now, no solution had been found.
Surgery and radiotherapy are generally used in the treatment of cancer. In many cases a large part of the lymph nodes is removed from lymph areas situated near the tumour(s).
As a result of damage to the primary lymph drainage channels, for example, as may result from surgery and radiation treatment, a reduced lymph transportation capacity can occur in this case in the areas concerned, which produces so-called xe2x80x9crelative lymphostasisxe2x80x9d, or the clinical oedema-free stage. In this stage, pathological changes, such as accumulations of fibrinoid material, already occur in the tissue. In lymphostasis or its manifestationxe2x80x94oedemaxe2x80x94we see accumulations of plasma proteins in the tissue. Both in relative lymphostasis and in lymphostasis, these plasma proteins are responsible for the inflammatory stimulation which maintains a non-specific inflammatory reaction in the tissue, which is a characteristic tissue reaction in relative lymphostasis and lymphostasis.
On account of the above, the pain symptoms experienced post-operatively by oncology patients who have undergone mainly axillary and inguinal lymph gland dissection can be defined as chronic lymph circulation disturbances in which primarily painful congestion and inflammation occur, so-called hyperalgesia.
Hyperalgesia in the operated hemithorax (the half of the trunk) and the corresponding arm or in the operated lower half of the trunk and the corresponding leg generally occurs in the clinical oedema-free stage, both in intermittent reversible oedema and in slight to moderate oedema.
More severe forms of hyperalgesia occur in the case of malignant lymph oedema and with the occurrence of acute radiation reactions during radiation treatment. In an acute radiation reaction, due to hyperaemia caused by the heat effect, increased permeability of the capillary blood vessels to plasma proteins occurs. At the point where a painful protein-rich swelling already existed after the operation, a severe form of hyperalgesia occurs in the form of a stinging, burning feeling. In this context we could mention seroma formation, haematoma formation, infiltration, slow-healing wounds, infection and in general all situations in which post-operatively an increased concentration of plasma proteins is already present in the tissue.
The above symptoms are of a subchronic to chronic nature and can be readily overcome in particular following the use of manual lymph drainage (MLD). Manual lymph drainage is a special form of non-forcing massage. Manual lymph drainage promotes the reabsorption of (protein-rich) tissue fluid in blood and lymph capillaries and stimulates the motor function of the lymph vessels, with the result that the lymph transportation capacity increases and the symptoms decline or disappear. (Relative) lymphostasis in the abovementioned areas is prevented or relieved here by increasing the tissue pressure from the outside.
The aetiology, pathogenesis and treatment of hyperalgesia, in this case by manual lymph drainage and compression therapy, constitutes an entirely new area within lymphology.
The object of the invention is to overcome the abovementioned problems and indicate a solution by which the beneficial effects of manual lymph drainage in the supraclavicular area, the armpit folds front and back, the shoulder area and/or the cranial trunk areas (anterior and posterior) in a patient are consolidated and/or increased.
This is achieved in the case of a compression hose according to the invention through the fact that the shoulder part is lengthened in such a way that when in use it extends past the h-line running vertically from the armpit to the shoulder line, and through the fact that the shoulder part is widened in such a way that when in use it covers at least an area on the trunk, which is at least bounded by a band-shaped fastening means running from the ipsilateral shoulder, around the front of the trunk to the contralateral side of the trunk in the area of the patient""s waist, and around the back of the trunk to the ipsilateral shoulder, such that the band-shaped fastening means forms an acute angle relative to a g-line, which is defined as a horizontal line running between the armpits at the respective ipsilateral and contralateral sides of the trunk, and a boundary line running from the patient""s armpit to the band-shaped fastening means, whereas the shoulder part exerts an approximately constant, adequate tissue pressure when in use.
A lengthened and widened shoulder part is known per se from GB-2242818. This British patent application describes protective garments, in particular a protective garment for keeping the shoulder joint warm. The known garment comprises various types of elastic material with a differing degrees of elasticity. The shoulder part thereof has undergone a special treatment, as a result of which it retains heat better.
The known protective garment with lengthened and widened shoulder part is entirely unsuitable for the object of the present invention, i.e. for the treatment of hyperalgesia, in this case for consolidating and increasing the beneficial effects of manual lymph drainage in the relevant abovementioned areas of the human body. The envisaged heat effect of the known garment in fact promotes the formation of oedema, and consequently of hyperalgesia. In addition, the known garment exerts an abruptly changing tissue pressure on the tissue, due to the use of a combination of materials with differing degrees of elasticity. On the other hand, the compression devices according to the present invention treats hyperalgesia by exerting an approximately constant pressure through the shoulder part thereof, whereas the remaining part comprises an arm compression hose which preferably exerts a gradually decreasing tissue pressure as the length of the arm compression hose is traversed from the distal (i.e., hand and/or wrist) to the proximal (i.e., the shoulder end of the arm) end.
In a further embodiment the shoulder part is made wider at the front and back of the trunk of the patient. In this embodiment the compression hose will slip little, if at all, after fastening, with the result that pressure is exerted on the tissue at the correct points.
In a further embodiment the shoulder part is slightly preshaped. The compression hose according to this embodiment can advantageously be adapted to the anatomical shape of the trunk area of the particular patient which runs between an h-line, a g-line, and the band shaped fastening device (mentioned above), as described further below, when this area of the patient and requires treatment.
In a further advantageous embodiment the compression hose is provided, at at least one place at the side next to the body, with a lining pocket for the accommodation of a compression pad, in order to increase the local tissue pressure. In this embodiment the tissue pressure can advantageously be increased further locally, in order to give optimum pain relief. The corresponding pressure change has a gradual course, viewed from distal to proximal, even when a compression pad according to the invention is used. This compression hose is suitable in particular for treating cases of severe hyperalgesia.
The present invention also relates to compression pants of elastic material provided with legs, which in use at least partially cover the upper legs of a patient.
In practice, such compression pants of elastic material are known, for example, cycle racing shorts.
The object of the invention is to make the known compression pants suitable for local consolidation and/or increasing of the beneficial effects of manual lymph drainage in the treatment of hyperalgesia in the area to be covered by the compression pants.
To this end, the compression pants according to the invention are characterized in that, at at least one place at the side next to the body, they are provided with a lining pocket for the accommodation of a compression pad, in order to increase the local tissue pressure.
The compression pants according to the invention make it possible also to exert an increased tissue pressure on congested or damaged lymph areas in, inter alia, the hip and/or abdomen area, the pubic area and/or the groin area of the patient.
The present invention also relates to a compression pad for use in the compression hose and/or the compression pants, in which the shape of the compression pad is adapted to the anatomical shape of the place on the body of the patient on which the compression pad exerts pressure when in use. Such a compression pad provides a non-forcing pressure from the outside on the congested and painful area concerned, with the result that the tissue pressure locally rises further, and the effect of the MLD is consolidated and/or increased, and recurrence of hyperalgesia is counteracted when the MLD has ended.